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Journal of the Medical Sciences (Berkala Ilmu Kedokteran)
Published by Universitas Gadjah Mada
ISSN : 01261312     EISSN : 23563931     DOI : http://dx.doi.org/10.19106/JMedSci005303202101
Core Subject : Science,
Immunology & microbiology Neuroscience
Journal of the Medical Sciences (JMedSci) or Berkala Ilmu Kedokteran (BIK) is an international, open-access, and double-blind peer-reviewed journal, published by Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada Yogyakarta Indonesia. JMedSci aiming to communicate high-quality articles in the areas of biomedical science from basic to clinical sciences.The journal welcomes papers from original articles, case reports, reviews, and book reviews. All papers published in JMedSci are freely available as downloadable pdf files. The journal began its publication on March 1973 and published quarterly (January, April, July, and October). JMedSci is abstracted and indexed in DOAJ, Crossref, Google Scholar, Sinta, Indonesia One Search. JMedSci is accredited by Directorate of General Higher Education, the Ministry of Research, Technology, and Higher Education, Indonesia
Arjuna Subject : Kedokteran - Kedokteran (Lain-Lain)
Articles 2,170 Documents
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Profile of patients diagnosed as sepsis (ICD X: A41.9) in the Internal Medicine Ward Sardjito Hospital in 2002 Yanri Wijayanti Subroto, Yanri Wijayanti Subroto
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 35, No 4 (2003)
Publisher : Universitas Gadjah Mada

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Abstract

Background: Sardjito Hospital as the top referral hospital for the Yogyakarta Special Province and the southern part of Central Java has a mortality rate of 56.83% of patients diagnosed as sepsis (ICD X A41.9). The overall hospital sepsis case in the year 2002 was 275, with 50.54% (139) of which was treated in the Internal Medicine ward. Out of the 139 cases, 44.60% was man and 55.40% was woman. Method: This study was focused on the identification of demographic and clinical factors of patients diagnosed as sepsis (ICD X A41.9) in Internal. Medicine ward Sardjito Hospital in 2002. Demographic data include sex, age, system of hospital admission (referral or self admition. Clinical data include the concomitant disease(s), causes of death, and type of cultured microorganism(s). The identification of these factors may be beneficial for designing an early warning system for fatal cases of patients with sepsisResults: Only 120 (86.33%) out of 139 medical records were eligible for further analysis. Seventy-one (59.17%) patients died in the hospital, whereas 49 (40.83%) were discharged from the hospital, but mostly were forced leave (only 6 patients were discharged in a good condition). The median ± SD age was 53.5 ± 15.99 years old with the youngest age was 17 and the oldest was 98. More than 50% of patients were above 50 years old. As many as 72 (60%) patients were admitted to the hospital referred by other hospitals (a few numbers were referred by private physicians), and only 48 (40%) patients were self-admitted. The average length of hospitalization was 6.96 ± 5.43 days, with the range of 1-25 days. The cause of death of these patients were mostly septic shock (61.97%), followed by respiratory failure (19.72%), intracranial process (14%), cardiac arrest (2.8%) and MOFS (1.4%). The underlying/concomitant diseases are:. gastrohepatology (mostly hepatic cirrhosis and hepatocellular carcinoma); hematology (acute leukemia, multiple myeloma), pulmonology (TB, COPD, pneumonia), oncology (Ca mammae, Ca cervix); endocrinology (DM type 2 with ulcus diabeticum), nephrology (chronic renal failure), cardiology (congestive heart failure), obsgyn (septic puerpuralis) and trop-med (urinary tract infection, malaria), etc.Conclusion: We report here research on medical record of patients diagnosed as sepsis (ICD X: A41.9) in Internal Medicine ward Dr. Sardjito Hospital in 2002. There were 139 cases with only 120 were eligible for analysis. Mortality reached 59.17% of cases with median of age 53.5 years and average length of hospitalization of 6.96 days. The most common cause of death was septic shock and gastrohepatology as the most common comorbid disease.Key words: sepsis-demographic-clinical presentation-cause of death
The efficacy of vaginally compared to orally administered misoprostol in inducing labor in term early ruptured membrane Hariadi, Hariadi
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 34, No 03 (2002)
Publisher : Universitas Gadjah Mada

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Abstract

Background: Misoprostol is now widely used as an agent for the induction of labor, although the effectiveness of its use in premature rupture of the membrane is questionable.Objectives: To compare the effectiveness of vaginal versus oral administration of misoprostol for induction of labor in term pregnancy with premature rupture of the membranes.Study Design: A retrospective cohortMaterials and Method: The study was conducted at Dr. Sardjito General Hospital Yogyakarta from January 1999 to November 2001. Data were taken from medical record. The inclusion criteria were gestational age of 37 weeks not yet in labor with premature rupture of membranes, singleton gestation, cephalic presentation, reactive fetal heart pattern, and Bishop score s 4. The pregnancy that is complicated by diseases were excluded. Vaginal administration of misoprostol was considered as the exposed group while oral administration was as control. Misoprostol 50 mg had been at six hours interval, for maximal dose of 200 pg. Variable outcomes were effectiveness, duration of induction, mode of delivery, side effects, and newborn asphyxia. Data were processed with SPSS for Window version 10.0, t-Test, chi-square test, relative risk, and binary logistic regression were used for statistical analysis.Result: During the period of three years, there had been 249 cases of premature rupture of membranes that met the inclusion and exclusion criteria consisting of 88 cases exposed group and 88 cases of control. The success rate of the vaginal misoprostol was 80.70% compared to 87.50% in the oral misoprostol with p > 0.05. The cesarean rate from vaginal misoprostol and oral misoprostol were 8.00% versus 3.40% respectively (RR 2.23 and 95% CI 0.62-8.73), the rate of asphyxia in the newborn was 29.50% versus 26.10% (RR 1.13 and 95% CI 0.70-1.82). The rate of side effect, hyperstimulation, was 5.70% versus 1.10% (RR 5.00 and 95% CI 0.60-41.93) in the vaginal group. The length of induction vaginal and oral misoprostol were 10.00 ± 4.86 and 9.76 ± 4.56 hours. There was one case of cesarean section followed with hysterectomy due to urine atony in the vaginal group.Conclusion: The success rate of vaginal misoprostol induction was slightly lower than oral, but it was not statistically significant, as well as the incidence of the first minute of asphyxia. The interval between the administration of drug to complete dilatation in the vaginal and oral group was not different. The rate of cesarean section and hyperstimulation was higher in the vaginal group.Key words: misoprostol - oral and vaginal - effectiveness - premature rupture of membranes - neonatal .asphyxia
Inappropriate use of antibiotics in the treatment of acute respiratory infections for the underfive children among general practitioners. Iwan Dwiprahasto, Iwan Dwiprahasto
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 29, No 02 (1997)
Publisher : Universitas Gadjah Mada

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Abstract

Acute respiratory infection (ARI) is the commonest illness in children and the leading cause of morbidity and mortality in many developing countries. It comprises approximately 50% of all illness in children under five years. Unfortunately, most children are commonly treated inappropriately. A population based study involving all general practitioners (GPs) and pharmacies in Yogyakarta Special Province was carried out in June-July 1992 to provide data on antibiotic utilization for acute respiratory infection (ARI). One hundred and ninety one out of 207 GPs and all pharmacies participated in the study by completing structured form distributed during the study. Ninety three percent of patients with ARI seen by GPs were given antibiotic. Based on WHO criteria on ARI, only 7-14% of all patients were eligible to be given antibiotics. The most frequently used antibiotics for the underfives were ampicillin (38.8%) followed by cotrimoxazole (29.2%), amoxycillin (14.9%), and erythromycin (6.13%). Sixty three per cent of drug cost prescribed for the underfives children were accounted for by antibiotics. It can be concluded that inappropriate use of antibiotics was found in more than 75% patients under 5 years of age. In addition to poor indication for antibiotic use inappropriateness was also found in terms of dose, the length of antibiotic use, drug administration, and drug dosage form.Key words: ARI - innapropriate use of antibiotics - underfive children - general practitioners - prescribing pattern
Comparative efficacy of Phyllanthus niruri L. and cotrimoxazole in the treatment of skin infection caused by Staphylococcus aureus. Praseno, Praseno
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 33, No 02 (2001)
Publisher : Universitas Gadjah Mada

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Abstract

Background: Traditional medicine has been widely used in our community and many of them were found to be effective in the treatment of various diseases. Previous studies showed that Phyllanthus niruri L. has an effect as immunostimulator and antiviral activities.Objective: The aim of this study was to evaluate the efficacy of Phyllanthus niruri L. in the treatment of skin infection caused by Staphylococcus aureus.Materials and Methods: Thirty mice of Swiss strain were infected with 2x100 colony forming unit of S.aureus subcutaneously. The mice were then devided into 3 groups; Phyllanthus niruri L.-treated group, cotrimoxazole-treated group, and control group. Treatmen
Detection of circulating antigen in sera of patients with malayan 1ilariasis by sandwich ELISA using monoclonal antibody Fes7 Soeyoko, Soeyoko
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 31, No 03 (1999)
Publisher : Universitas Gadjah Mada

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Abstract

Background. The living lymphatic filarial worm Brugia malayi releases physiologically protein materials in the malayan filariasis patients which is called circulating antigen. Based on the clinical symptoms and the demonstration of microfilariae in the blood smears, people who are living in the endemic area can be classified into 4 groups: symptomatic microfilaraemic, symptomatic amicrofilaraemic, asymptomatic microfilaraemic and asymptomatic amicrofilaraemic.Objectives. To detect circulating antigen in sera of each group of patients with malayan filariasis in endemic area.Methods. Circulating antigen in sera was detected by sandwich ELISA using monoclonal antibody Fesi.Result. By sandwich ELISA using monoclonal antibody Fesi, 100% of symptomatic microfilaraemic sera, 35.7% of symptomatic amicrofilaraemic sera, 89.2% of asymptomatic microfilaraemic sera and 26.3% of asymptomatic amicrofilaraemic sera were positive for circulating antigen.Conclusion. Detection of circulating antigen in sera of malayan filariasis patients could be used to support the diagnosis of malayan filariasis in some cases which were difficult to be diagnosed by conventional method based on clinical symptoms and the demonstration of microfilariae in the blood smears.Keywords: circulating antigen - sandwich ELISA - monoclonal antibody - sera - Brugia malayi - asymptomatic amicrofilaraemic.
Relationship between explanations of cause of mental illness and the strengthening of being religious Soewadi, Soewadi
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 30, No 02 (1998)
Publisher : Universitas Gadjah Mada

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The misconception of disease and health of people is influenced by belief In supernatural spirits or magic. This study was designed to contribute to our understanding of the relationship between perceived cause of illness and religious strength. A study was carried out In the Facuity of Medicine Gadjah Mada University, Yogyakarta, Indonesia, among first year students. Data were analyzed using Chi square technique (Mantel Haenszel) and contingency correlation coefficient. The results of the study showed that there was no significant difference between groups of subjects who believed and did not believe in supernatural cause of mental illness according to the religious strength (X2 = 0.88; p>0.05). The results Identified some of the subjects (52.9%) believed in supernatural cause of mental illness and there was also a correlation between such beliefs and the religious strength (C.0 = - 0.13). It was concluded that there was no relationship between perceived cause of mental Illness and the religious strength.Key words : mental Illness - religious - anxiety - mysticism - believe
Absolute and relative lymphocyte counts in dengue infection Bambang Ardianto, Bambang Ardianto
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 34, No 04 (2002)
Publisher : Universitas Gadjah Mada

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Abstract

Background: Dengue infection is one of Indonesias health problems. Lymphocytes are thought to be involved in dengue pathogenesis.Objectives: To determine whether there were any differences on absolute and relative lymphocyte counts between dengue and non-dengue febrile patients and among dengue fever (DF), dengue hemorrhagic fever without shock (DHF, dengue shock syndrome (DSS), and non-dengue (ND) patients.Methods: A cross-sectional study was conducted on dengue and non-dengue patients hospitalized at "Empat Lima" Hospital, Yogyakarta, during the period of November 23, 2001-January 22, 2002. The diagnosis of dengue infection was confirmed by HI test. Absolute and relative lymphocyte counts were obtained from serial peripheral blood films stained with Giemsas staining.Results: Thirty-eight DF, 10 DHF, 16 DSS, and 86 ND patients were involved in this study. Absolute and relative counts of each degree were compared each other from the third day until the eighth day after the onset of fever. Absolute lymphocyte counts of dengue patients were higher than those of non-dengue patients on day 5 (p=0.047) and 6 (p =0.022). Absolute lymphocyte counts of DHF patients were higher than those of DF, DSS, and ND patients on day 5 (DF vs. DHF, p =0.003; DHF vs. DSS, p=0.001; ND vs. DHF, p(0.001).Absolute lymphocyte counts of DHF patiens were higher than those of ND patiens on day 6(p=0.018).Relative lymphocyte counts of Df patiens were higher than those of DSSpatiens on day 6(p=0.023), while relative lymphocyte counts of ND patiens were higher than those of DSS patiens on day 7 (p=0.026).Conclution:there were significant differences in absolute lymphocyte counts between dengue and nondengue patiens, DF and DSS patiens, and ND and DSS patiens.Key words:lymphocyte count, dengue infection, dengue shock syndrome, non-dengue infection
Antiviral activity of Momordica charantia: a preliminary study on in vitro anti herpes simplex virus Praseno, Praseno
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 29, No 03 (1997)
Publisher : Universitas Gadjah Mada

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Abstract

Traditional medication has been used by Indonesian people since long time ago and still continuing up to the present time. Many of them proved to be effective in curing various diseases. In this study an in vitro activity of Momordica charantia againts Herpes Simplex Virus type 2 has been evaluated by standard method of plaque reduction assay. The aim of this study is to determine whether traditional medicine we are searching has an antiviral activity. The results showed that total inhibition of plaque formation on HSV 2-infected Vero cell line was achieved at concentration of 8% v/v of crude extract, whereas the concentration of 1% v/v was capable of reducing the number of plaques by approximately 50% (inhibitory dose50= ID50). These results were very interesting as even with only small amount of crude extract we could get ID50. We expect that much lower concentration will be required to obtain ID50 if we use purified extract in the assay. Further studies are needed to elucidate other properties of the extract, including its in vivo antiviral activity, possible effect on other viruses, and mechanism of action.Key words: antiviral activity - herpes simplex virus - Momordica charantia - traditional medicine - plaque reduction assay
In vitro antiplasmodial activity of 1,10- phenanthroline derivatives and its quantitative structure-activity relationship Mustofa, Mustofa
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 35, No 2 (2003)
Publisher : Universitas Gadjah Mada

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Background: Previous study showed that 1,10-phenanthroline skeleton were active in vitro on both Plasmodium falciparum chloroquine-resistant and -sensitive strains. Based on the skeleton, a series of 1,10-phenanthroline derivatives have been synthesized. However the antiplasmodial activity of those molecules has not been reported.Objective: To know the in vitro antiplasmodial activity of thirteen 1,10-phenantroline derivatives and its quantitative structure-activity relationship.Methods: The in vitro antiplasmodial activity was tested on two strains of Plasmodium falciparum, FcB1Columbia (chloroquine-resistant strain) and a Nigerian (chloroquine-sensitive strain) using a radioactive micromethod. The parasite growth was estimated by [3H1-hipoxanthine incorporation after 24 and 48 hours incubation with each molecule tested. The control parasite free from any molecules was referred to as 100% growth. For this radioactive method IC5o value showing concentration inhibiting 50% of the parasite was determined graphically in concentration versus percent inhibition curves. The quantitative structure-activity relationships (QSAR) of 1,10-phenanthroline derivatives were investigated using atomic net charges as predictors of their activity. Data of predictors were obtained using semi-empirical Austin Model 1 (AM1) calculation method. The possible linear relationships of in vitro antiplasmodial activity with atomic net charge parameters of those compounds were studied. The best model QSAR was evaluated by multiple linear regression method.Results: The results showed that the IC5o values of 1,10-phenanthroline derivatives range from 0.02 to 11.05 uM for the FcB1 strain and from 0.14 to 19.84 pM for the Nigerian strain. The molecure (4), 2,10- methy1-3-12-chloroethyl)-4-chloropirydo [2,3-i] quinolineium iodide exhibited the best in vitro antiplasmodial activity with an IC50 value ranging 0.02 to 0.16 1.1M. The best model QSAR was expressed by log IC5o = -3.4398 - 14.9050 qN1 - 8.5589 qC10 - 14.7565 qC7 + 5.0457 qC11 (n = 13; r = 0.96275; r2 = 0.92689; SE = 0.61578 and F (4,8) = 25.3556).Conclusion: The molecule (4) yield the best in vitro antiplasmodial activity on both P. falciparum strains. In addition, there is correlation between antiplasmodial activity and atomic net charges of atoms on the 1,10-phenanthroline skeleton.Key words : 1,10-phenanthroline, antiplasmodial activity, quantitative structure-activity relationships
Retinochoroiditis Toxoplasmika Kongenital yang Menyebabkan Juling Nunuk Maria Ulfah, Suhardjo, Nunuk Maria Ulfah, Suhardjo
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 20, No 02 (1988)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

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Four cases of 1- to 12-year old children with strabismus were reported. In all cases no abnormality of both the motoric and the refractive media of the eye were found. On the other hand, funduscopic examination revealed macular and retinal lesions in the form of rosette pigmentation and pseudocoloboma which were suggestive of the existence of congenital toxoplasmic retinochoroiditis.This suggestion was confirmed to be true with serologic examination for Taxopla,sma. It was thought that the squintness was secondary to the congenital toxoplasmic retinochoroiditis and possible mechanism was discussed.Key Words: toxoplasmic retinochoroiditis — disturbance of binocular vision — strabismus — rosette pigmentation — latex agglutination

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